|
HC SOM BK VIRUS DNA QUANT PCR
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC SOM BK VIRUS DNA QUANT PCR
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
900912559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$314.39 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$42.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$314.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$188.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$261.67
|
| Rate for Payer: Blue Shield of California Commercial |
$37.80
|
| Rate for Payer: Blue Shield of California EPN |
$23.82
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.69
|
| Rate for Payer: EPIC Health Plan Senior |
$47.12
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$70.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.41
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$42.84
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Prime Health Services Medicare |
$45.41
|
| Rate for Payer: Riverside University Health System MISP |
$47.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.70
|
| Rate for Payer: United Healthcare All Other HMO |
$34.70
|
| Rate for Payer: United Healthcare HMO Rider |
$34.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.12
|
| Rate for Payer: Vantage Medical Group Senior |
$42.84
|
|
|
HC SOM BLASTOMYCES AB EIA
|
Facility
|
OP
|
$43.94
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900915370
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Adventist Health Commercial |
$8.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Blue Shield of California Commercial |
$27.68
|
| Rate for Payer: Blue Shield of California EPN |
$17.44
|
| Rate for Payer: Cash Price |
$43.94
|
| Rate for Payer: Cash Price |
$43.94
|
| Rate for Payer: Central Health Plan Commercial |
$35.15
|
| Rate for Payer: Cigna of CA HMO |
$28.12
|
| Rate for Payer: Cigna of CA PPO |
$32.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.29
|
| Rate for Payer: EPIC Health Plan Senior |
$14.19
|
| Rate for Payer: Galaxy Health WC |
$37.35
|
| Rate for Payer: Global Benefits Group Commercial |
$26.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.29
|
| Rate for Payer: Multiplan Commercial |
$32.95
|
| Rate for Payer: Networks By Design Commercial |
$28.56
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$37.35
|
| Rate for Payer: Prime Health Services Medicare |
$13.67
|
| Rate for Payer: Riverside University Health System MISP |
$14.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.45
|
| Rate for Payer: United Healthcare All Other HMO |
$10.45
|
| Rate for Payer: United Healthcare HMO Rider |
$10.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.45
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: Vantage Medical Group Senior |
$12.90
|
|
|
HC SOM BLASTOMYCES AB EIA
|
Facility
|
IP
|
$43.94
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900915370
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$39.55 |
| Rate for Payer: Adventist Health Commercial |
$8.79
|
| Rate for Payer: Cash Price |
$43.94
|
| Rate for Payer: Central Health Plan Commercial |
$35.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.58
|
| Rate for Payer: EPIC Health Plan Senior |
$17.58
|
| Rate for Payer: Galaxy Health WC |
$37.35
|
| Rate for Payer: Global Benefits Group Commercial |
$26.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.79
|
| Rate for Payer: Multiplan Commercial |
$32.95
|
| Rate for Payer: Networks By Design Commercial |
$28.56
|
| Rate for Payer: Prime Health Services Commercial |
$37.35
|
|
|
HC SOM BLASTOMYCES AB IMMUNODIFFUSION
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900912686
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Blue Shield of California Commercial |
$15.75
|
| Rate for Payer: Blue Shield of California EPN |
$9.93
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.29
|
| Rate for Payer: EPIC Health Plan Senior |
$14.19
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.29
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$13.67
|
| Rate for Payer: Riverside University Health System MISP |
$14.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.45
|
| Rate for Payer: United Healthcare All Other HMO |
$10.45
|
| Rate for Payer: United Healthcare HMO Rider |
$10.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.45
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.19
|
| Rate for Payer: Vantage Medical Group Senior |
$12.90
|
|
|
HC SOM BLASTOMYCES AB IMMUNODIFFUSION
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
900912686
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$25.00
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC SOM BLOOM CULTURE 01
|
Facility
|
IP
|
$937.09
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900915282
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$187.42 |
| Max. Negotiated Rate |
$843.38 |
| Rate for Payer: Adventist Health Commercial |
$187.42
|
| Rate for Payer: Cash Price |
$937.09
|
| Rate for Payer: Central Health Plan Commercial |
$749.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$655.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$374.84
|
| Rate for Payer: EPIC Health Plan Senior |
$374.84
|
| Rate for Payer: Galaxy Health WC |
$796.53
|
| Rate for Payer: Global Benefits Group Commercial |
$562.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$843.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$595.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.42
|
| Rate for Payer: Multiplan Commercial |
$702.82
|
| Rate for Payer: Networks By Design Commercial |
$609.11
|
| Rate for Payer: Prime Health Services Commercial |
$796.53
|
|
|
HC SOM BLOOM CULTURE 01
|
Facility
|
OP
|
$937.09
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
900915282
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.36 |
| Max. Negotiated Rate |
$1,000.31 |
| Rate for Payer: Adventist Health Commercial |
$187.42
|
| Rate for Payer: Adventist Health Medi-Cal |
$116.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$855.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$116.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$719.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,000.31
|
| Rate for Payer: Blue Shield of California Commercial |
$590.37
|
| Rate for Payer: Blue Shield of California EPN |
$372.02
|
| Rate for Payer: Cash Price |
$937.09
|
| Rate for Payer: Cash Price |
$937.09
|
| Rate for Payer: Central Health Plan Commercial |
$749.67
|
| Rate for Payer: Cigna of CA HMO |
$599.74
|
| Rate for Payer: Cigna of CA PPO |
$693.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$174.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$128.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$655.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.21
|
| Rate for Payer: EPIC Health Plan Senior |
$128.14
|
| Rate for Payer: Galaxy Health WC |
$796.53
|
| Rate for Payer: Global Benefits Group Commercial |
$562.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$843.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$191.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$173.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$116.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$595.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$163.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$156.10
|
| Rate for Payer: Multiplan Commercial |
$702.82
|
| Rate for Payer: Networks By Design Commercial |
$609.11
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$116.49
|
| Rate for Payer: Prime Health Services Commercial |
$796.53
|
| Rate for Payer: Prime Health Services Medicare |
$123.48
|
| Rate for Payer: Riverside University Health System MISP |
$128.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$562.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$562.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.36
|
| Rate for Payer: United Healthcare All Other HMO |
$94.36
|
| Rate for Payer: United Healthcare HMO Rider |
$94.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$94.36
|
| Rate for Payer: Upland Medical Group Pediatric |
$116.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$174.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$128.14
|
| Rate for Payer: Vantage Medical Group Senior |
$116.49
|
|
|
HC SOM BNP 83880
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900914724
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.16 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Adventist Health Commercial |
$34.16
|
| Rate for Payer: Cash Price |
$170.78
|
| Rate for Payer: Central Health Plan Commercial |
$136.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.31
|
| Rate for Payer: EPIC Health Plan Senior |
$68.31
|
| Rate for Payer: Galaxy Health WC |
$145.16
|
| Rate for Payer: Global Benefits Group Commercial |
$102.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$108.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.16
|
| Rate for Payer: Multiplan Commercial |
$128.09
|
| Rate for Payer: Networks By Design Commercial |
$111.01
|
| Rate for Payer: Prime Health Services Commercial |
$145.16
|
|
|
HC SOM BNP 83880
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
900914724
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.80 |
| Max. Negotiated Rate |
$343.38 |
| Rate for Payer: Adventist Health Commercial |
$34.16
|
| Rate for Payer: Adventist Health Medi-Cal |
$39.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$249.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$246.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$343.38
|
| Rate for Payer: Blue Shield of California Commercial |
$107.59
|
| Rate for Payer: Blue Shield of California EPN |
$67.80
|
| Rate for Payer: Cash Price |
$170.78
|
| Rate for Payer: Cash Price |
$170.78
|
| Rate for Payer: Central Health Plan Commercial |
$136.62
|
| Rate for Payer: Cigna of CA HMO |
$109.30
|
| Rate for Payer: Cigna of CA PPO |
$126.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$58.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$39.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.78
|
| Rate for Payer: EPIC Health Plan Senior |
$43.19
|
| Rate for Payer: Galaxy Health WC |
$145.16
|
| Rate for Payer: Global Benefits Group Commercial |
$102.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$64.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$108.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$57.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$52.61
|
| Rate for Payer: Multiplan Commercial |
$128.09
|
| Rate for Payer: Networks By Design Commercial |
$111.01
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$39.26
|
| Rate for Payer: Prime Health Services Commercial |
$145.16
|
| Rate for Payer: Prime Health Services Medicare |
$41.62
|
| Rate for Payer: Riverside University Health System MISP |
$43.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.80
|
| Rate for Payer: United Healthcare All Other HMO |
$31.80
|
| Rate for Payer: United Healthcare HMO Rider |
$31.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$39.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$58.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.19
|
| Rate for Payer: Vantage Medical Group Senior |
$39.26
|
|
|
HC SOM BONE ALKALINE PHOSPHATASE
|
Facility
|
IP
|
$26.50
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
900915326
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$23.85 |
| Rate for Payer: Adventist Health Commercial |
$5.30
|
| Rate for Payer: Cash Price |
$26.50
|
| Rate for Payer: Central Health Plan Commercial |
$21.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10.60
|
| Rate for Payer: Galaxy Health WC |
$22.52
|
| Rate for Payer: Global Benefits Group Commercial |
$15.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.30
|
| Rate for Payer: Multiplan Commercial |
$19.88
|
| Rate for Payer: Networks By Design Commercial |
$17.23
|
| Rate for Payer: Prime Health Services Commercial |
$22.52
|
|
|
HC SOM BONE ALKALINE PHOSPHATASE
|
Facility
|
OP
|
$26.50
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
900915326
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$149.59 |
| Rate for Payer: Adventist Health Commercial |
$5.30
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$149.59
|
| Rate for Payer: Blue Shield of California Commercial |
$16.70
|
| Rate for Payer: Blue Shield of California EPN |
$10.52
|
| Rate for Payer: Cash Price |
$26.50
|
| Rate for Payer: Cash Price |
$26.50
|
| Rate for Payer: Central Health Plan Commercial |
$21.20
|
| Rate for Payer: Cigna of CA HMO |
$16.96
|
| Rate for Payer: Cigna of CA PPO |
$19.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.39
|
| Rate for Payer: EPIC Health Plan Senior |
$16.26
|
| Rate for Payer: Galaxy Health WC |
$22.52
|
| Rate for Payer: Global Benefits Group Commercial |
$15.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.85
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.81
|
| Rate for Payer: Multiplan Commercial |
$19.88
|
| Rate for Payer: Networks By Design Commercial |
$17.23
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.78
|
| Rate for Payer: Prime Health Services Commercial |
$22.52
|
| Rate for Payer: Prime Health Services Medicare |
$15.67
|
| Rate for Payer: Riverside University Health System MISP |
$16.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.97
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14.78
|
|
|
HC SOM BORDETELLA PCR
|
Facility
|
IP
|
$38.80
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914165
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$34.92 |
| Rate for Payer: Adventist Health Commercial |
$7.76
|
| Rate for Payer: Cash Price |
$38.80
|
| Rate for Payer: Central Health Plan Commercial |
$31.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.52
|
| Rate for Payer: EPIC Health Plan Senior |
$15.52
|
| Rate for Payer: Galaxy Health WC |
$32.98
|
| Rate for Payer: Global Benefits Group Commercial |
$23.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.76
|
| Rate for Payer: Multiplan Commercial |
$29.10
|
| Rate for Payer: Networks By Design Commercial |
$25.22
|
| Rate for Payer: Prime Health Services Commercial |
$32.98
|
|
|
HC SOM BORDETELLA PCR
|
Facility
|
OP
|
$38.80
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900914165
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$343.45 |
| Rate for Payer: Adventist Health Commercial |
$7.76
|
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$343.45
|
| Rate for Payer: Blue Shield of California Commercial |
$24.44
|
| Rate for Payer: Blue Shield of California EPN |
$15.40
|
| Rate for Payer: Cash Price |
$38.80
|
| Rate for Payer: Cash Price |
$38.80
|
| Rate for Payer: Central Health Plan Commercial |
$31.04
|
| Rate for Payer: Cigna of CA HMO |
$24.83
|
| Rate for Payer: Cigna of CA PPO |
$28.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.90
|
| Rate for Payer: EPIC Health Plan Senior |
$38.60
|
| Rate for Payer: Galaxy Health WC |
$32.98
|
| Rate for Payer: Global Benefits Group Commercial |
$23.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.92
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$57.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$29.10
|
| Rate for Payer: Networks By Design Commercial |
$25.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$35.09
|
| Rate for Payer: Prime Health Services Commercial |
$32.98
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Riverside University Health System MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$35.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM BORIC ACID
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900911050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: EPIC Health Plan Senior |
$35.20
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
|
|
HC SOM BORIC ACID
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900911050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$188.47 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$21.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$161.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.47
|
| Rate for Payer: Blue Shield of California Commercial |
$55.44
|
| Rate for Payer: Blue Shield of California EPN |
$34.94
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.23
|
| Rate for Payer: EPIC Health Plan Senior |
$24.16
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.43
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21.96
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$23.28
|
| Rate for Payer: Riverside University Health System MISP |
$24.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.78
|
| Rate for Payer: United Healthcare All Other HMO |
$17.78
|
| Rate for Payer: United Healthcare HMO Rider |
$17.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: Vantage Medical Group Senior |
$21.96
|
|
|
HC SOM BORON
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900914503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$65.70 |
| Rate for Payer: Adventist Health Commercial |
$14.60
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Central Health Plan Commercial |
$58.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$51.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.20
|
| Rate for Payer: EPIC Health Plan Senior |
$29.20
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$46.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$43.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Multiplan Commercial |
$54.75
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
|
|
HC SOM BORON
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
900914503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$188.47 |
| Rate for Payer: Adventist Health Commercial |
$14.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$21.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$161.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.47
|
| Rate for Payer: Blue Shield of California Commercial |
$45.99
|
| Rate for Payer: Blue Shield of California EPN |
$28.98
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Cash Price |
$73.00
|
| Rate for Payer: Central Health Plan Commercial |
$58.40
|
| Rate for Payer: Cigna of CA HMO |
$46.72
|
| Rate for Payer: Cigna of CA PPO |
$54.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$51.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.23
|
| Rate for Payer: EPIC Health Plan Senior |
$24.16
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$46.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.43
|
| Rate for Payer: Multiplan Commercial |
$54.75
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21.96
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
| Rate for Payer: Prime Health Services Medicare |
$23.28
|
| Rate for Payer: Riverside University Health System MISP |
$24.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.78
|
| Rate for Payer: United Healthcare All Other HMO |
$17.78
|
| Rate for Payer: United Healthcare HMO Rider |
$17.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.16
|
| Rate for Payer: Vantage Medical Group Senior |
$21.96
|
|
|
HC SOM BORRELIA BURGDORFERI PCR DETECT
|
Facility
|
OP
|
$26.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$343.45 |
| Rate for Payer: Adventist Health Commercial |
$5.33
|
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$343.45
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$10.59
|
| Rate for Payer: Cash Price |
$26.67
|
| Rate for Payer: Cash Price |
$26.67
|
| Rate for Payer: Central Health Plan Commercial |
$21.34
|
| Rate for Payer: Cigna of CA HMO |
$17.07
|
| Rate for Payer: Cigna of CA PPO |
$19.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.90
|
| Rate for Payer: EPIC Health Plan Senior |
$38.60
|
| Rate for Payer: Galaxy Health WC |
$22.67
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$57.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$35.09
|
| Rate for Payer: Prime Health Services Commercial |
$22.67
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Riverside University Health System MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$35.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM BORRELIA BURGDORFERI PCR DETECT
|
Facility
|
IP
|
$26.67
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
900915376
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Adventist Health Commercial |
$5.33
|
| Rate for Payer: Cash Price |
$26.67
|
| Rate for Payer: Central Health Plan Commercial |
$21.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.67
|
| Rate for Payer: EPIC Health Plan Senior |
$10.67
|
| Rate for Payer: Galaxy Health WC |
$22.67
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.34
|
| Rate for Payer: Prime Health Services Commercial |
$22.67
|
|
|
HC SOM BORRELIA BURGDORFERI PCR PROBE
|
Facility
|
OP
|
$26.66
|
|
|
Service Code
|
CPT 87476
|
| Hospital Charge Code |
900912513
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$343.45 |
| Rate for Payer: Adventist Health Commercial |
$5.33
|
| Rate for Payer: Adventist Health Medi-Cal |
$35.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$247.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$343.45
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$10.58
|
| Rate for Payer: Cash Price |
$26.66
|
| Rate for Payer: Cash Price |
$26.66
|
| Rate for Payer: Central Health Plan Commercial |
$21.33
|
| Rate for Payer: Cigna of CA HMO |
$17.06
|
| Rate for Payer: Cigna of CA PPO |
$19.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.90
|
| Rate for Payer: EPIC Health Plan Senior |
$38.60
|
| Rate for Payer: Galaxy Health WC |
$22.66
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.99
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$59.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$47.02
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.33
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$35.09
|
| Rate for Payer: Prime Health Services Commercial |
$22.66
|
| Rate for Payer: Prime Health Services Medicare |
$37.20
|
| Rate for Payer: Riverside University Health System MISP |
$38.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.42
|
| Rate for Payer: United Healthcare All Other HMO |
$28.42
|
| Rate for Payer: United Healthcare HMO Rider |
$28.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$35.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.60
|
| Rate for Payer: Vantage Medical Group Senior |
$35.09
|
|
|
HC SOM BORRELIA BURGDORFERI PCR PROBE
|
Facility
|
IP
|
$26.66
|
|
|
Service Code
|
CPT 87476
|
| Hospital Charge Code |
900912513
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$23.99 |
| Rate for Payer: Adventist Health Commercial |
$5.33
|
| Rate for Payer: Cash Price |
$26.66
|
| Rate for Payer: Central Health Plan Commercial |
$21.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.66
|
| Rate for Payer: EPIC Health Plan Senior |
$10.66
|
| Rate for Payer: Galaxy Health WC |
$22.66
|
| Rate for Payer: Global Benefits Group Commercial |
$16.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$17.33
|
| Rate for Payer: Prime Health Services Commercial |
$22.66
|
|
|
HC SOM BPAB IMMUNOASSAY NONANTIBODY
|
Facility
|
OP
|
$62.50
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900915527
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$236.61 |
| Rate for Payer: Adventist Health Commercial |
$12.50
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$170.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.61
|
| Rate for Payer: Blue Shield of California Commercial |
$39.38
|
| Rate for Payer: Blue Shield of California EPN |
$24.81
|
| Rate for Payer: Cash Price |
$62.50
|
| Rate for Payer: Cash Price |
$62.50
|
| Rate for Payer: Central Health Plan Commercial |
$50.00
|
| Rate for Payer: Cigna of CA HMO |
$40.00
|
| Rate for Payer: Cigna of CA PPO |
$46.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$43.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$53.12
|
| Rate for Payer: Global Benefits Group Commercial |
$37.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$56.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$46.88
|
| Rate for Payer: Networks By Design Commercial |
$40.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.53
|
| Rate for Payer: Prime Health Services Commercial |
$53.12
|
| Rate for Payer: Prime Health Services Medicare |
$12.22
|
| Rate for Payer: Riverside University Health System MISP |
$12.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC SOM BPAB IMMUNOASSAY NONANTIBODY
|
Facility
|
IP
|
$62.50
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900915527
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.50 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Adventist Health Commercial |
$12.50
|
| Rate for Payer: Cash Price |
$62.50
|
| Rate for Payer: Central Health Plan Commercial |
$50.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$43.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.00
|
| Rate for Payer: EPIC Health Plan Senior |
$25.00
|
| Rate for Payer: Galaxy Health WC |
$53.12
|
| Rate for Payer: Global Benefits Group Commercial |
$37.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$56.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.50
|
| Rate for Payer: Multiplan Commercial |
$46.88
|
| Rate for Payer: Networks By Design Commercial |
$40.62
|
| Rate for Payer: Prime Health Services Commercial |
$53.12
|
|
|
HC SOM BRUCELLA AB CONFIRMATION
|
Facility
|
OP
|
$21.06
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
900912841
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$81.57 |
| Rate for Payer: Adventist Health Commercial |
$4.21
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.57
|
| Rate for Payer: Blue Shield of California Commercial |
$13.27
|
| Rate for Payer: Blue Shield of California EPN |
$8.36
|
| Rate for Payer: Cash Price |
$21.06
|
| Rate for Payer: Cash Price |
$21.06
|
| Rate for Payer: Central Health Plan Commercial |
$16.85
|
| Rate for Payer: Cigna of CA HMO |
$13.48
|
| Rate for Payer: Cigna of CA PPO |
$15.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$9.82
|
| Rate for Payer: Galaxy Health WC |
$17.90
|
| Rate for Payer: Global Benefits Group Commercial |
$12.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.97
|
| Rate for Payer: Multiplan Commercial |
$15.79
|
| Rate for Payer: Networks By Design Commercial |
$13.69
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.93
|
| Rate for Payer: Prime Health Services Commercial |
$17.90
|
| Rate for Payer: Prime Health Services Medicare |
$9.47
|
| Rate for Payer: Riverside University Health System MISP |
$9.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.24
|
| Rate for Payer: United Healthcare All Other HMO |
$7.24
|
| Rate for Payer: United Healthcare HMO Rider |
$7.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.82
|
| Rate for Payer: Vantage Medical Group Senior |
$8.93
|
|
